PT - JOURNAL ARTICLE AU - Omair Ali AU - Abdul Wase TI - Anomalous venous circuit: a detour to the heart AID - 10.1136/bcr-2012-006680 DP - 2012 Nov 21 TA - BMJ Case Reports PG - bcr2012006680 VI - 2012 4099 - http://casereports.bmj.com/content/2012/bcr-2012-006680.short 4100 - http://casereports.bmj.com/content/2012/bcr-2012-006680.full AB - We report a case of a complicated vascular access secondary to systemic venous defects, which have not been previously reported. Evaluation revealed an atypical coursing of a subclavian vein-persistent superior vena caval system into the hemizygos–azygos system and ultimately into the right (proper) superior vena cava. The clinical and surgical considerations of such an anomaly are discussed therein. We look at embryological origins of such a merger and share our experience in troubleshooting through the anomaly.